title: [Posterocentral approach to the posterior tibial plateau. Reconstruction of tibial plateau fractures and avulsions of the posterior cruciate ligament].
abstract: BACKGROUND
  For surgical treatment of posterior shearing tibial plateau fractures and avulsion fractures of the posterior cruciate ligament (PCL) a posterocentral approach without dissection or separation of the heads of the gastrocnemius muscle is used. The aim of this study was an evaluation of this approach.
  
  
  METHODS
  From 2001-2012 a total of 33 patients were surgically treated using a posterocentral approach to the dorsal knee joint. Of these patients 22 had a posterior shearing tibial plateau fracture and 11 had an avulsion fracture of the PCL. The fracture type, complications, expertise of the surgeon, fracture healing, implant position and irritation, nerve lesions, scar tissue and range of motion were documented.
  
  
  RESULTS
  Hypesthesia around the scar, at the lateral foot and lower lateral leg were observed in one each of three patients. Despite two ventral implant infections no infection of the dorsal implant occurred. All scar tissue was without pathological findings and scar contracture was not observed. In three cases the screw tips at the anterior proximal tibia were palpable but without complaints from the patients.
  
  
  CONCLUSIONS
  The posterocentral approach showed a low complication rate in the hands of experienced surgeons. The soft tissue cover seems to prevent implant infections.
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie, Westpfalz-Klinikum, Kaiserslautern, Akademisches Lehrkrankenhaus der Medizinischen Fakultät Mannheim, Ruprecht-Karls-Universität Heidelberg und Johannes-Gutenberg-Universität Mainz, Hellmut-Hartert-Straße 1, 67655, Kaiserslautern, Deutschland, mmuhm@westpfalz-klinikum.de.
authors.forename: M
authors.initials: M
authors.lastname: Muhm
authors.forename: P
authors.initials: P
authors.lastname: Schneider
authors.forename: T
authors.initials: T
authors.lastname: Ruffing
authors.forename: H
authors.initials: H
authors.lastname: Winkler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000601:surgery*; D016119:Posterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome